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Trifascicular block with intermittent complete atrioventricular block in a child
1Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan, ROC.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|December 31, 1997
Summary
Trifascicular block is rare in children with healthy hearts. This case highlights its diagnosis via electrocardiography and successful management with a temporary pacemaker, leading to a good clinical outcome.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Trifascicular block, affecting the heart's three main conduction fascicles, can lead to severe atrioventricular block.
- It is uncommon in children with structurally normal hearts.
Observation:
- A previously healthy 9-year-old girl presented with seizures and electrocardiogram findings of complete right bundle branch block, left axis deviation, and prolonged PR interval.
- Intermittent high-degree and complete atrioventricular block were observed, suggestive of underlying myocarditis despite normal cardiac enzymes.
Findings:
- Electrocardiography is crucial for diagnosing trifascicular block.
- The patient's condition resolved with a temporary pacemaker, restoring normal sinus rhythm within 3 days.
Implications:
- Prompt diagnosis and management of trifascicular block in children can lead to favorable outcomes.
- This case underscores the importance of electrocardiographic evaluation in pediatric patients presenting with conduction abnormalities.